A 25-y-old Percheron mare was admitted to the teaching hospital because of lethargy and intractable dyspnea. Thoracoabdominal ultrasound examination identified severe peritoneal effusion, mild bilateral pleural effusion, and a diffuse pulmonary nodular pattern. Cytology of peritoneal fluid revealed a hypercellular sample with clusters of neoplastic polygonal cells and admixed macrophages. Euthanasia was followed by postmortem examination; marked bi-cavitary effusion was present, and innumerable up to 4-cm diameter, round-to-floriform nodules were diffusely evident throughout serosal surfaces as well as the pulmonary and hepatic parenchyma. Disseminated adenocarcinoma, predominantly affecting lung and liver with widespread serosal implantation, was confirmed on light microscopy. Neoplastic cells had strong immunolabeling for pancytokeratin and lacked immunoreactivity to vimentin, napsin A, and Pax8. Cytokeratin 7 and thyroid transcription factor-1 were non-contributory given absent and inconsistent internal control reactivity, respectively. Such results, combined with the lack of a major mass that would indicate a primary site, were supportive of carcinoma of unknown primary site, which remains a conundrum in human oncology, and is poorly explored in veterinary medicine, mainly as a result of clinical and diagnostic limitations.
Objectives
To describe the surgical findings, histopathological features, and long‐term outcome for a horse with parotid salivary carcinoma.
Study design
Case report
Animals
Twelve year old American Quarter Horse gelding.
Methods
The gelding was presented for a 10 × 10 cm swelling below the base of the right ear. Ultrasonographic examination revealed a mass involving the right parotid salivary gland. Incisional biopsy was consistent with parotid carcinoma. The tumor was marginally excised. The lateral wall of the guttural pouch was excised with the mass and was reconstructed with a porcine small intestinal submucosal (SIS) sheet. Cisplatin beads were implanted in the wound bed prior to closure. Firocoxib (0.1 mg/kg orally, daily, every 24 h) treatment was initiated.
Results
Postoperative complications included right‐sided facial nerve paralysis, difficulty with deglutition of fibrous feeds, and surgical site dehiscence. Wound healing was achieved by second intention. Partial improvement in nerve function was observed within the first 6 months. At 12 months postparotidectomy, no sign of tumor reoccurrence or metastatic disease was present, and the gelding returned to work.
Conclusion
Partial parotid sialoadenectomy was performed with a favorable long‐term outcome. Regional anatomic knowledge is crucial.
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